Three Big Questions About an Austin Medical School

A replacement for 'ailing' Brackenridge hospital is pitched as part of a medical school for Austin.

Daniel Reese for KUT News

Last month, hopes for a vote on urban rail were dashed.

Despite years of discussion, preliminary routes, and an estimate of the cost, Austin Mayor Lee Leffingwell shot down the idea, saying plans lacked “a sufficient level of certainty” to put a proposal before voters in November.

There were political considerations too. Momentum’s building in the long push for a medical school at UT-Austin – and should public funding be required, backers had warned against asking voters to approve tax increases for urban rail and a medical school all at once.

This week, flyers started appearing in Austin mailboxes, supporting the concept of a local medical school.

But like the delayed rail vote, several questions persist regarding the creation of a medical school and new teaching hospital:

Where would the school and hospital be located?

What would become of Austin’s existing university hospital, Brackenridge?

Will voters be asked to approve a tax increase? And if so, how much?

There have been several developments in relation to the campaign so far. In April, Seton Healthcare Family, which currently operates University Medical Center Brackenridge, said it would spend $250 million on a new teaching hospital – an intrinsic part of a medical school.

Soon afterward, the University of Texas Board of Regents proposed $30 million in annual funding for a medical school for the first eight years, and $25 million annually after that.

What we don’t know, right now, is whether a proposal to fund the medical school will appear on the ballot this November.

“All things health care are complicated,” says Patricia Young Brown, the President and CEO of Central Health. Approved by voters in 2004, Central Health is a tax-funded entity that provides care to the Travis County region. It owns the Brackenridge hospital, which Seton operates.

If a tax increase to finance the medical school were to be put to voters this year, Central Health is the jurisdiction that would bring it forward. But Brown says Central Health is currently focused on how to leverage matching federal dollars for health care under a specific Medicaid waiver.

“The state has instituted a new program that basically allows us to use local, public funds to draw down federal matching dollars related to the delivery of health care services,” Brown says.

Those matching dollars – in the form of a Medicaid 1115 waiver – are based on “the extent that we can institute new services and care delivery systems,” she continues. “So we are in the process of doing an analysis to see what we might be able to draw down from that federal program, and that would impact how much local funding we would need in order to draw down those funds. So we might be looking at the potential of a tax rate election.”

Seton Medical Center President and CEO Greg Hartman concurs that his group and Central Health have been collaborating on developing a new operational agreement. That could include a medical school, which Hartman says would help Seton care for more patients than it currently serves at Brackenridge.

“University Medical Center Brackenridge right now is an ailing hospital,” Hartman says. “It’s a very old building; it’s been added to several times. … It provides great care right now, but it clearly could use replacement. And so, the thinking has been we could have a medical school with a great teaching hospital that could attract some wonderful clinical experts from around the country, and at the same time have a hospital that better cares for our population.”

But in some ways, the discussion of a new hospital is separate from the conversation surrounding the medical school.

“Almost all the parts of the entire continuum of medical education, except for the first two years of medical school, are here already,” says Hartman. “The medical school is really just the final little piece of that. … And so the medical school is important. But the new hospital, and the new operating agreement [with Central Health] … is a significant conversation to have, regardless of a medical school.”

Hartman adds that any potential tax election “is really more connected to the medical school” than a new hospital – which it sounds like Seton is interested in pursuing regardless.

Central Health’s Brown echoes Hartman, saying any extra taxes raised by Central Health would go toward “what we do as providing medical or health care services to the community. Facilities involved in the efforts would be funded by other agencies, not us.”

The group promoting the medical school, Healthy ATX, has been mum so far on funding details. State Sen. Kirk Watson, the prime proponent of a medical school, recently co-authored an op-ed with UT-Austin President Bill Powers stating “our community would be responsible for a relatively small percentage of the medical school’s cost— roughly 10 percent on average over the next decade, and a smaller amount over time.”

But the exact contribution county residents will be asked to make is unknown at this time – along with the potential location of Seton’s new hospital.

As far as location goes, Seton’s Hartman says his organization is “looking at a variety of different options” in the area Brackenridge currently occupies, around 15th and Red River streets, and also near the new Dell Children’s Hospital in the nascent Mueller development.

“It will definitely be in the urban core,” he says. “My guess is it’ll be probably somewhere near the existing Brackenridge, or near Dell Children’s – that would be the best guess, I think.” He says Seton is also exploring redeveloping Brackenridge for other medical purposes like check-ups and clinical services – and classroom and conference space, should a medical school be forthcoming.

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